I was at a chiropractor yesterday and he looked at my feet and said I have Morton's toe (second toe is longer than first toe), I had never heard of it so I found it interesting. But what I did find interesting is that he said Morton's toe leads to very inefficient running and is the source of many biomechanics problems in running. Has anyone heard of this being a source of injuries and are there any ways to minimize the effects? I do seem to be injury prone to running.

Only thing I know of is Morton's neuroma, an inflammation of the nerve between the 2nd and 3rd toes...pretty painful, believe me. I started using shoes with more cushion in the forefoot and haven't had trouble since. I guess that because the 2nd toe is longer than the first, it causes pressure between the 2nd and 3rd toes when you push off and the bones constrict the nerve. It starts to feel like someone is pounding on the ball of your foot with a hammer. More cushion allows the foot to spread a little as it pushes off. ________________________________________________________________________ "that which does not destroy me will only make me stronger" Frederick Nietzsche andrew peabody http://BREAKAWAYMULTISPORT.COM

I'm not a doctor, therapist, or chiro, but I've never heard of this. Morton's Neuroma, yes, but a second toe longer that the first causing biomechanical issues is new to me. My second toe is considerably longer than the first, but I have never had any issues because of it at any distance.

I have had orthopods and physical therapists poking and prodding various parts of my lower extremeties for the better part of a decade and that has never been raised as anything.

Like I said, I had never heard of Morton's toe causing biomechanical problems before either. This was the first time I had been to this chiropractor and he seemed pretty good. But now I dont know if I should think that he is really really good since others hadnt heard of it....or a real quack?

Rule of thumb with Morton is long second toe and usually high arches. As far as shoes go, most Morton folks do better with straight lasted shoes so the long spot on the shoe lines up with the second toe being longest. There are three types of shoes ,curved or banana lasted(shoe looks like that) semi curved which is a half curve last, and straight lasted which the left and right shoes look almost alike from below.

Not sure as to the whys, but ask a good shoe man and they can tell you more. G

I have morton's toe. It's never been a problem for me. I am biomechanically efficient (according to video analysis from my podiatrist), and haven't suffered too many injuries. I have also run a 30:30 10k on the track, and a 2:20 marathon, so I don't think my funny second toe makes me too slow.

"Definition Morton's Toe is a common forefoot disorder where the second toe is longer than the Big Toe (the Hallux).

Cause Morton's toe leads to excessive pressure on the second metatarsal head resulting in pain similar to the discomfort associated with metatarsalgia.

The constant pressure placed on the longer second toe while walking or standing can lead to callus formation under the second metatarsal head due to this excessive pressure.

Treatment Proper treatment of Morton's Toe starts with selecting proper footwear or arch supports. Footwear with a high and wide toe box is ideal for treating this condition. It may be necessary to buy footwear a half size larger to accommodate the longer second toe.

Prevention Orthotics that feature arch support to keep the foot aligned, and a metatarsal pad to reduce stress on the ball-of-the-foot are often recommended when treating this condition. Proper footwear combined with a effective orthotic will provide relief from pain associated with Morton's Toe."

Depends upon why the toe is long - is it the proximal phalanx or metatarsal (more likely). You are perhaps more prone to a stress fx of the 2nd met or 2nd MPJ capsulitis. I rarely see someone with "perfect" biomechanics (same with the spine). There is always something that I can point to and say "see, this is a problem. Not normal." If you have been running for a while a not having any problems, don't give it a second throught. If you are having issues here - then that is another story. ____________________________________ Fatigue is biochemical, not biomechanical. - Andrew Coggan, PhD

Wow, talk about coincidence. I was just about to post a question about pain between my 2nd and third toes, on the ball of my foot. Not so coincidentally, my 2nd toe is ever-so-slightly longer than my first, and I have to have a certain shape of shoe in the front to avoid severely-blackened toenails. The pain seems to run from just behind the ball to just in front, and hurts when I step on it. I've never had this problem before, and have many thousands of miles on the bike and many hundreds running in the last 2-3 years. However...I always use a high arch support in my shoes, and I was wearing sandals with very little arch support for the last 3 days after racing the 1/2 at GFT on Saturday. At this point I am just hoping that it goes away before IMFL next weekend...'cause I can see it being a real pain in the...er...foot. Any solutions other than keep off of it? Charter Member - HED Mafia

I have Morton's toe, but unlike another poster I'm flat footed. I've never experienced any real foot problems, except those caused by high heels - probably not a problem for most of the guys on this forum - though I have had a lot of foot pain on the bike. The pain starts on the ball of my foot directly under that toe, and goes forward until the whole front of my foot feels like a screaming ball of pain. I don't have the pain all the time, however, and I doubt it has anything to do with the toe, anyway.

I'm a confirmed MOPer, so maybe I can blame my mediocre run speed on my toe.

Sounds like either an acute capsulitis of the MPJ(s) or an early Morton's neuroma. They are basically treated the same here (with the intention of IMFL soon that is, otherwise it will likely go away based on your history and an exact diagnosis is not even necessary).

Aggressively ice the area several times a day - about 5 mins per episode. Fill some styrofoam cups with water, freeze them, then use that (after peeling off a layer) to massage the ball of the foot. Avoid going barefoot (or sandals) and stay in your running shoes at all times, even at work. Take ibuprofen (if you can and have no stomach issues, I'm making several assumptions here) at about 600-800mg (3 to 4 pills) 2 to 3 times per day. If you don't have some rapid improvement, consider getting a local corticosteroid injection to get you through the race. It will likely hurt during the race though, and after, the post IM well deserved rest "should" take care of it.

Good luck - I plan on IMFL next year: too bad I won't be there this year or I could just block the nerve before the start and say good luck! ____________________________________ Fatigue is biochemical, not biomechanical. - Andrew Coggan, PhD

Thanks for the advice, I am actually already doing most of that. I am currently taking Advil on a lower level (2 pills in the morning), and am wearing a super-cushioned running shoe right now. I iced it last night, but only once. I'll have to do it a few more times, but with these shoes on it didn't particularly bother me even before the advil kicked in. I've had a few people tell me Aleve is better for things like this, any experience with Aleve? Charter Member - HED Mafia

Morton's can cause problems, most of which can be solved with orthotics, and/or mechanical (stride) adjustments and/or stretching.

The mechanics of the foot/ankle when running are that (optimally) the foot lands slightly to the outside edge (supinated) perhaps 3-4º. As weight transfers forward, the foot pronates 4-6º, then supinates 1-3º on toe-off. The only things that really matter here are that that if the foot moves excessively (pronates or supinates) then stress is being transfered into the ankle and the knee - which is then moving laterally and is not designed to do so - and if the weight bears off the foot over the big toe, the arch of the foot tightens, straining the plantar fascia and the Achilles tendon.

As an experiment, slowly roll your weight straight forward until you toe off using the big toe as your lever. Notice how tight your arch feels. No repeat the experiment, but allow or force your weight to bear off over the smaller toes and notice how much your arch relaxes with this motion.

Some folks with Mortons have a challenge getting that last bit of supination correct so that the big toe doesn't take the entire load or alternately the foot doesn't supinate excessively, causing problems at the knee and ankle.

At one time (back in the '70s) it was considered by many that Morton's was a death sentance for runners. Now that we understand the mechanism of running better (thanks to the many sports-med labs that have sprung up) we find that for nearly every challenge, there is a solution. Cousin Elwood - Team Over-the-hill Racing Brought to you by the good folks at Metamucil and Geritol...

I have this too and have been able to run over 60 miles in a week w/o injury. My PT diagnosed this and has shown me the literature on it so I understand what's going on. We discovered it based on hip pain of all things. the muscles in my hip are overworked because my knee doesn't track straight (see Cousin Elwood's post). This is likely caused by a strength limiter and my morton's toe.

What hasn't been mentioned and may be unique to me (or not) is that the problem isn't the second toe going forward too far, but the big toe not going back far enough. When I'm in pawback the second toe is handling the majority of the force and weight since the big toe is too short to be activated. It's effectively hanging in mid-air. this leads to excessive blistering on that pad due to additional friction. He has built a morton's extension into my orthotics to try to help compensate and balance the foot across all the pads.

I'd recommend that you ask your chiro to fill you in on the research he's following, or find someone who is interested in explaining well to you what's going on, instead of treating you like an uninvolved party.

good luck. don't give up, think of all the extra work a challenged athlete faces. morton's toe is chump change. and don't forget, Lance has won the TdF six times with only one ball!

Alleve is fine too - same pharmacologic effect as ibuprofen. Needs to be 2 pills, twice per day (OTC dose is 200 or 220 mg if compounded as a salt. Rx dose of naprosyn is 500mg twice per day).

Benefit of alleve is that it has about a 12 hour half life whereas ibuprofen last about 4-6. Drawback is that some have more renal hypertension with it or fluid retention/edema. In an otherwise healthy person, it makes no real difference - use what works.

Since you have been (per your own words) biking for thousands of miles and running hundreds for the past 2-3 years and this is the first incidence of this (and possibly related to known improper footwear), your biomechanics are probably NOT an issue. Knock yourself out with home excercise/stretching though if you want. If it seems to return or is chronic, that is another issue.

Again, good luck in FL - I heard the bridges are still out though getting there! ____________________________________ Fatigue is biochemical, not biomechanical. - Andrew Coggan, PhD

1x (one-by) is the popular designation for single chainring, no front derailleur. It's at least a moderate hit for SRAM in both MTB (XX1) and cross (CX1). tri (TX1?) seems poised to be next. Would you give this serious consideration for your next tri bike?